Provider Demographics
NPI:1285659169
Name:DELYAEI, JACQUELINE JADE (MD)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JADE
Last Name:DELYAEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 MAIN STREET
Mailing Address - Street 2:DOCTORS ON DUTY URGENT CARE CLINIC
Mailing Address - City:WATSOVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076
Mailing Address - Country:US
Mailing Address - Phone:831-722-1444
Mailing Address - Fax:
Practice Address - Street 1:1505 MAIN STREET
Practice Address - Street 2:DOCTORS ON DUTY URGENT CARE CLINIC
Practice Address - City:WATSOVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076
Practice Address - Country:US
Practice Address - Phone:831-722-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96268207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine